CT appearances of amyloid lymphadenopathy in a patient with non-Hodgkin's lymphoma

Amyloidosis is a rare but recognized complication of non-Hodgkin's lymphoma (NHL). Most patients have evidence of irreversible systemic amyloid deposition associated with an extremely poor prognosis and, in the majority, a limited life expectancy. Lymphadenopathy secondary to amyloid infiltration is uncommon. We report an unusual case of massive amyloid lymphadenopathy related to underlying low-grade NHL, which has followed an indolent clinical course over the last 16 years. Lymphadenopathy in this patient showed unique imaging appearances with many of the enlarged nodes showing areas of diffuse low density, presumably related to amyloid deposition. Although imaging findings in amyloidosis are often non-specific and diverse, these particular features have not to our knowledge been previously described. When these radiological findings are present in the appropriate clinical setting, we suggest that the possible diagnosis of amyloidosis should be considered.